Orthotics - Footwear for Diabetic patients

Introduction

This leaflet is produced for people with Diabetes who have been provided with footwear by the Orthotics service. It will explain how to care for the footwear and other important information about the Orthotics service.

We hope you find this information useful.

If you require any further information or if you are unable to attend an appointment, please telephone the Orthotics department where the appointment has been made as soon as possible:

Bury, Rochdale or Oldham: 0161 778 2670
Email: nca.orthotics@nca.nhs.uk

Salford: 0161 206 4912
Email: salford.orthotics@nca.nhs.uk

For further information about our service, please visit:

www.northerncarealliance.nhs.uk/our-services/orthotics

Our sites are open for collection and dropping off devices:

Bury: Tuesdays only
Rochdale: Thursdays only
Oldham: Mondays only
Salford: Monday - Friday

What problems should I be aware of?

Diabetes can cause damage to blood vessels leading to poor circulation, particularly in the feet and legs. It can also cause nerve damage which can lead to numbness and loss of feeling.

These problems can result in the following:

• Injury, sores or ulcers on the foot which you don’t notice
• Injury, sores or ulcers which get infected easily and take a long time to heal
• Bony swelling or deformity (Charcot foot)
• Mobility difficulties that can affect the way you stand and walk
• In severe cases of damage, or if problems with the foot are ignored, the tissue in the foot may die (become gangrenous) and it may be necessary to remove (amputate) toes, part of the foot or even the lower leg

What can I do to prevent problems occurring?

You should examine your feet regularly to check for cuts, scratches, swellings, inflammation or discolouration. If you can’t check your own feet you should ask someone to do it for you.

What problems should I be aware of?

It is essential that you check your feet daily. If you do notice any of the following, please contact the Orthotics department as soon as possible:

• Sores, blisters or ulcers on the foot
• Changes in skin colour (if it becomes blacker, bluer, redder or whiter)
• Any damage to the footwear
• Excessive wear to the footwear

If you notice any change in temperature in your skin, particularly an increase in temperature over the top of your foot you should contact your Diabetic team or GP as soon as possible.

What do the shoes do?

The shoes with which you have been supplied have been prescribed by the Orthotist for your specific foot condition. They are designed to maximise comfort and reduce the risk of problems occurring due to ill-fitting footwear.

What is my entitlement?

You are entitled to two pairs of footwear. However, if your feet are likely to change, we will only issue one pair at a time.
 
Following initial supply of your first pair of shoes you will be provided with a follow-up appointment, at which point, if the footwear is satisfactory, then a further pair will be ordered.

We will ensure you have two pairs of wearable footwear*. These will only be replaced when they are beyond repair, or if your clinical condition changes and the footwear cannot be altered to accommodate these changes.

We do not provide sandals and slippers, as these do not meet clinical requirements.

*Wearable footwear is defined as fit for purpose and part of this includes prompt and necessary repair. Failure to ensure that footwear is maintained correctly may result in a charge being levied on replacement footwear, when such replacement is due to incorrect maintenance.

Repair of footwear

When the shoes need repairing please bring them to the Orthotics department and providing the footwear has been looked after, we will repair them. Please note for health and safety reasons footwear will only be accepted for repair if it is in a clean, dry condition.

Theft, loss or damage to your footwear

If your footwear is stolen you will need to obtain a crime number from the police before we are able to order a replacement.
 
If the footwear is lost or damaged (either accidentally or maliciously) you will be asked to pay for its replacement. The average cost of replacement stock footwear is £350. Made to measure footwear is £600 for shoes and £800 for boots.

How should I wear my shoes?

Take time to get used to the footwear, the following wear schedule is recommended:

• The initial wear period should be for approximately 30 – 45 minutes. After this time remove the footwear and your socks and visually check your feet for marks (get someone to help you with this if necessary). Marks which disappear after approximately 5 – 10 minutes should not be a problem but this will need checking regularly
• Following a break of approximately 30 minutes put the footwear on again for a further 30 – 45 minutes and then repeat the checking procedure
• This process should be repeated daily with the time of wear being increased by 10 – 15 minutes each day

Once you can wear your footwear for approximately 3 hours with no marking then the bedding-in process is complete, and you should be able to wear your footwear all day as required

• Wash your feet daily and ensure you wear the shoes with clean, seam-free socks
• Ensure the shoes are fastened securely
• Have the shoes repaired when necessary by the Orthotic department
• Always check inside your shoe before putting it on to ensure that nothing has fallen inside

How should I care for my footwear?

• Clean your footwear regularly, with shoe polish for leather and a brush for suede or nubuck
• Allow to dry naturally, away from direct heat sources such as the radiator
• You are responsible for looking after your shoes and returning them for repair
• Ensure that you wear the shoes with the insoles with which they were provided

Further appointments

Following the supply of your first pair of shoes you will be sent an appointment to see the Orthotist for a review. It is essential that you attend this appointment. However, if you feel your condition has not improved, has worsened or you are experiencing problems with the footwear you can ask to see the Orthotist sooner, by telephoning the Orthotics department where you had your original appointment.